WORK APPLICATION
Last Name
Nyberg
First Name
Howard
Middle Name
S
Present Address (number, street, city, state, zip code)
**** ** ******* **/** Deerfield, Wisconsin 53531
Home Phone
E-Mail Address
*******@********.***
Alternate Phone
What shift(s) are you available to work?
First
Second
Third
Mornings
Afternoons
Evenings
Rotating
Weekend
Non-Standard
Types of Employment Preferred (Check more than one box if desired)
Permanent (Full Time)
Permanent (Part Time)
Temporary (Full Time)
Temporary (Part Time)
On Call
Project / Contract
On Call Temporary
Apprentice
Internship
What days are you available to work?
Monday-Friday
Weekends Only
Non-Standard
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Do you have transportation available?
Yes
No
Do you have a valid driver’s license?
Yes
No
Are you 18 or older?
Yes
No
Are you a veteran?
Yes
No
Desired Salary
EDUCATION AND TRAINING
Check the box next to the highest grade or year completed in school:
1
2
3
4
5
6
7
8
9
10
11
12
Do you have a High School Diploma, HSED, or GED?
Yes No
Highest grade completed in college
Name of School
Dates Attended
Course(s) of Study
Degree / Awards
From
To
Sunnyside School
7/2022
4/2023
ServeSafe
ServeSafe
Sunnyside School
7/2022
3/2023
ServeSafe
Sunnyside School
5/2022
2/2023
ServeSafe
ServeSafe
CERTIFICATIONS, LICENSES, AWARDS
ServeSafe Certified 2022 Through 2027
jobcenterofwisconsin.com
WORK EXPERIENCE
Employer
Sandridge Secure Treatment Center
From (Month/Year)
1/2004
To (Month/Year)
2/2023
City, State
Mauston, Wisconsin
Your Title(s)
Kitchen Assistant
Your Duties
• Add cutlery, napkins, food, and other items to trays on assembly lines in hospitals, cafeterias, airline kitchens, and similar establishments.
• Assemble meal trays with foods in accordance with patients' diets.
• Assist cooks and kitchen staff with various tasks as needed, and provide cooks with needed items.
• Carry food supplies, equipment, and utensils to and from storage and work areas.
• Clean and sanitize work areas, equipment, utensils, dishes, or silverware.
• Distribute menus to hospital patients, collect diet sheets, and deliver food trays and snacks to nursing units or directly to patients.
• Inform supervisors when equipment is not working properly and when food and supplies are getting low, and order needed items.
• Load dishes, glasses, and tableware into dishwashing machines.
• Mix ingredients for green salads, molded fruit salads, vegetable salads, and pasta salads.
• Prepare a variety of foods, such as meats, vegetables, or desserts, according to customers' orders or supervisors' instructions, following approved procedures.
• Prepare and serve a variety of beverages such as coffee, tea, and soft drinks.
• Remove trash and clean kitchen garbage containers.
• Store food in designated containers and storage areas to prevent spoilage.
• Take and record temperature of food and food storage areas, such as refrigerators and freezers.
• Use manual or electric appliances to clean, peel, slice, and trim foods.
• Vacuum dining area and sweep and mop kitchen floor.
• Wash, peel, and cut various foods, such as fruits and vegetables, to prepare for cooking or serving.
• Weigh or measure ingredients.
Employer
Sandridge Secure Treatment Center
From (Month/Year)
1/2004
To (Month/Year)
2/2023
City, State
Mauston, Wisconsin
Your Title(s)
Kitchen Assistant
Your Duties
• Add cutlery, napkins, food, and other items to trays on assembly lines in hospitals, cafeterias, airline kitchens, and similar establishments.
• Assemble meal trays with foods in accordance with patients' diets.
• Assist cooks and kitchen staff with various tasks as needed, and provide cooks with needed items.
• Butcher and clean fowl, fish, poultry, and shellfish to prepare for cooking or serving.
• Carry food supplies, equipment, and utensils to and from storage and work areas.
• Clean and sanitize work areas, equipment, utensils, dishes, or silverware.
• Cut, slice or grind meat, poultry, and seafood to prepare for cooking.
• Distribute food to waiters and waitresses to serve to customers.
• Distribute menus to hospital patients, collect diet sheets, and deliver food trays and snacks to nursing units or directly to patients.
• Inform supervisors when equipment is not working properly and when food and supplies are getting low, and order needed items.
• Keep records of the quantities of food used.
• Load dishes, glasses, and tableware into dishwashing machines.
• Mix ingredients for green salads, molded fruit salads, vegetable salads, and pasta salads.
• Package take-out foods or serve food to customers.
• Place food trays over food warmers for immediate service, or store them in refrigerated storage cabinets.
• Portion and wrap food, or place it directly on plates for service to patrons.
• Prepare a variety of foods, such as meats, vegetables, or desserts, according to customers' orders or supervisors' instructions, following approved procedures.
• Prepare and serve a variety of beverages such as coffee, tea, and soft drinks.
• Receive and store food supplies, equipment, and utensils in refrigerators, cupboards, and other storage areas.
• Remove trash and clean kitchen garbage containers.
• Scrape leftovers from dishes into garbage containers.
• Stir and strain soups and sauces.
• Stock cupboards and refrigerators, and tend salad bars and buffet meals.
• Store food in designated containers and storage areas to prevent spoilage.
• Take and record temperature of food and food storage areas, such as refrigerators and freezers.
• Use manual or electric appliances to clean, peel, slice, and trim foods.
• Vacuum dining area and sweep and mop kitchen floor.
• Wash, peel, and cut various foods, such as fruits and vegetables, to prepare for cooking or serving.
• Weigh or measure ingredients.
Employer
Sandridge Secure Treatment Center
From (Month/Year)
1/2004
To (Month/Year)
2/2023
City, State
Mauston, Wisconsin
Your Title(s)
Kitchen Assistant
Your Duties
• Add cutlery, napkins, food, and other items to trays on assembly lines in hospitals, cafeterias, airline kitchens, and similar establishments.
• Assemble meal trays with foods in accordance with patients' diets.
• Assist cooks and kitchen staff with various tasks as needed, and provide cooks with needed items.
• Carry food supplies, equipment, and utensils to and from storage and work areas.
• Clean and sanitize work areas, equipment, utensils, dishes, or silverware.
• Cut, slice or grind meat, poultry, and seafood to prepare for cooking.
• Distribute food to waiters and waitresses to serve to customers.
• Distribute menus to hospital patients, collect diet sheets, and deliver food trays and snacks to nursing units or directly to patients.
• Distribute menus to hospital patients, collect diet sheets, and deliver food trays and snacks to nursing units or directly to patients.
• Inform supervisors when equipment is not working properly and when food and supplies are getting low, and order needed items.
• Keep records of the quantities of food used.
• Load dishes, glasses, and tableware into dishwashing machines.
• Mix ingredients for green salads, molded fruit salads, vegetable salads, and pasta salads.
• Portion and wrap food, or place it directly on plates for service to patrons.
• Prepare a variety of foods, such as meats, vegetables, or desserts, according to customers' orders or supervisors' instructions, following approved procedures.
• Prepare and serve a variety of beverages such as coffee, tea, and soft drinks.
• Receive and store food supplies, equipment, and utensils in refrigerators, cupboards, and other storage areas.
• Remove trash and clean kitchen garbage containers.
• Scrape leftovers from dishes into garbage containers.
• Stock cupboards and refrigerators, and tend salad bars and buffet meals.
• Store food in designated containers and storage areas to prevent spoilage.
• Take and record temperature of food and food storage areas, such as refrigerators and freezers.
• Use manual or electric appliances to clean, peel, slice, and trim foods.
• Vacuum dining area and sweep and mop kitchen floor.
• Wash, peel, and cut various foods, such as fruits and vegetables, to prepare for cooking or serving.
• Weigh or measure ingredients.
Employer
From (Month/Year)
To (Month/Year)
City, State
Your Title(s)
Your Duties
SPECIFIC SKILLS
Preparing Food
Serving Food
Cleaning, Stripping & Waxing Floors, High Speed Buffer
References available upon Request